Doctor Answers 11

Healing After Tummy Tuck

October 18th, 2016

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A tummy tuck is a pretty big operation. A large amount of tissue is removed and, in the process, some stress is placed on the circulation of the tissue that remains behind. One potential result is that some of the wound edges may take some extra time to heal. I tell our patients that this is really about a 120 day process. The result that is seen on day 7 is different than the result that will be seen on day 120. Tissues are really swollen early during the healing and this adds some stress to the circulation. Swelling decreases quite a bit over the first 3 weeks, but often patients feel a bit bloated in the lower abdomen for about 3 or even 4 months. We see our patients frequently during this time of healing, even more frequently if there are any signs of wound healing problems. We encourage our patients to call any time of the day, night, or weekend if they have questions.

It's natural to go to the internet to look for answers to questions after surgery. Ultimately, though, the best place to go for answers is to the surgeon who performed the surgery. All surgeons want great outcomes for their patients. It's okay to be persistent in asking questions, and it's okay to require a few more office visits than the "typical" patient, especially if there are specific issues that need to be addressed.

Belly button

October 18th, 2016

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It appears you have some scabbing around your belly button but everything else looks like it is healing ok. It is common to have some areas of scanning early on after surgery. This should improve with more time

Tummy Tuck Pictures

Healing after TT

October 18th, 2016

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Thanks for your post. No, I don't get the sense from this photo that you are having significant necrosis or death of the tissues. It looks like some scabbing that occurs normally. Most of the belly button tissues look pink and healthy. I don't see photos of your actual incision. If you are concerned, please have your surgeon (or assistant) take another look today. It will likely resolve on its own. Best wishes.

Concerns with Incision Post-Op

October 22nd, 2016

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It may take several months for a tummy tuck patient’s scars to soften, for sensation to return, and for relaxing of the tight sensation in the abdomen. In the case of extensive surgery, abdominoplasty recovery can be uncomfortable and may take longer. Scars may stay red, become thick or widen. It can take 12-18 months for the scars to settle.

These can be improved with topical treatments such as BioCorneum, Scar Guard, Scar Fade and Mederma. Redness can be improved with laser treatments and the scars can be kept narrow with products such as Embrace. On occasion, keloids or hypertrophic scars can develop and will need treatment including Kenalog, 5FU and laser.

It is unfortunate that you find yourself concerned with your incision and your plastic surgeon is not personally available right now. With the PRN not providing and answer with which you are comfortable, there should be the number for an answering service to which you can refer while your surgeon is out of town. If you find yourself completely uncomfortable and without anyone else to turn it would likely be a good idea to visit the ER or your general practitioner to have the area examined to make sure that healing is progressing well. Good luck!

Doesn't look like skin necrosis

October 19th, 2016

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Based solely on your photos, you don't appear to have skin necrosis. Things look to be healing normally. However, if you symptoms worsen or change then yes, get in to see your surgeon or whoever it is that he or she has covering his patients while on vacation.

Rim of discoloration around belly button following tummy tuck

October 18th, 2016

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From the pictures you provided it is difficult to say for certain. The dark ring of discoloration at the margin of the belly button represents either some superficial crusting and/or some superficial ischemia. The circular incision around the belly button can stress the circulation to it. So the discoloration you see could be some superficial marginal skin edge ischemia/necrosis. Even if it is, I don't think it will affect the overall healing significantly, and in the end, I believe it will be of little significance. With the exception of this ring of discoloration, the rest of the belly button has a normal color and appears healthy. If this is a little marginal skin edge necrosis, since you already 6 days out from surgery, I don't think it is likely to get any worse.

I don't know if he will given any specific instructions to care for this incision. I usually have patients wash it gently, blot dry, and apply a thin layer of Polysporin antibiotic ointment to the suture line.

If you have additional concerns you can always send the same photographs to your surgeon. Best wishes.

Crusting?

October 18th, 2016

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There appears to be some crusting around the incision. This may or may not be normal. But usually if there is some minor issues at the incision edges, it often goes on to heal without significant issues. Best to follow closely with your surgeon.

Necrosis after tummy tuck?

October 18th, 2016

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Thank you for your question. The provided photo appears to show some superficial ischemia vs scab formation at the incision line where the belly button was inset. This does occur time to time after a tummy tuck. I personally have patients treat the belly button with triple antibiotic ointment for a week following surgery. At the one week follow-up, I evaluate all surgical sites and decide whether any incision sites/surgical sites need further care. I would discuss concerns with your surgeon. If your surgeon is out of town, they should have a physician covering their practice that can see you.

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